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Updated: Aug 5, 2026
Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
Temporary Spinal Cord Stimulation versus Dorsal Root Ganglion Pulsed Radiofrequency for Preventing Postherpetic
Penghui Ke1, Likui Wang1, Yang Song1
1Department of Pain Management, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Objectives:
Postherpetic neuralgia (PHN) is the most disabling complication of herpes zoster, and first-line agents give only modest relief. Temporary spinal cord stimulation (SCS) and dorsal root ganglion pulsed radiofrequency (DRG-PRF) are increasingly used for PHN prevention, but head-to-head real-world evidence at standard DRG-PRF parameters is lacking. We compared temporary SCS with standard DRG-PRF for six-month PHN prevention.
Materials And Methods:
In this single-center retrospective cohort (2020-2025), patients with herpes zoster-related neuralgia refractory to conservative therapy received temporary SCS or standard DRG-PRF (42 °C, three 120-second cycles). We performed 1:1 propensity-score matching on 15 baseline covariates. The primary outcome was a six-month composite of persistent pain (numeric rating scale [NRS] ≥4) and sustained medication use. The primary estimand was the marginal odds ratio (OR) calculated using generalized estimating equations with matched-pair cluster-robust standard errors; an E-value assessed unmeasured confounding.
Results:
Among 181 matched pairs from a 445-patient analytic cohort, the six-month composite PHN end point was less frequent with SCS than DRG-PRF (marginal OR 0.52, 95% CI, 0.31-0.89, p = 0.02; number-needed-to-treat 8.2). The direction was consistent across predefined sensitivity analyses (OR range, 0.43-0.74); the E-value was 2.12. The benefit appeared concentrated in nonthoracic dermatomes (interaction p = 0.07). Periprocedural complication rates were similar (13.3% vs 14.9%; p = 0.63), with technique-specific adverse event profiles.
Conclusions:
Temporary SCS was associated with lower six-month PHN incidence than standard DRG-PRF in this real-world cohort, with a consistent direction across sensitivity analyses. Multicenter prospective validation is warranted.
